<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="content-type" content="text/html; charset=utf-8" />
<title>Student Portal</title>
<script type="text/javascript" src="js/redirect.js"></script>
<link href="css/default.css" rel="stylesheet" type="text/css" media="screen"></link>
<link rel="stylesheet" type="text/css" href="css/form.css"></link>
<script type="text/javascript" src="js/jquery.js"></script>
<script type="text/javascript" src="js/jquery.validate.js"></script>
<script type="text/javascript" src="js/jquery.extend.js"></script>
<script type="text/javascript" src="js/redirect.js"></script>
</head>
<body>
	<!-- start header -->
	<%@ include file="components/header.jsp"%>
	<!-- end header -->
	
<div id="wrapper">
	<!-- start page -->
	<div id="page">

		<%@ include file="components/vertical_navigationbar.jsp"%>
		
		<!-- start content -->
			<div id="content">
			
              <form action="" id="studentforminadmin">
              			              <legend>Student Profile</legend>
              
                <div class="panel-heading">                
                <h4 class="panel-title">Student Details</h4>
              </div>
                <div class="panel-body">
                <fieldset>
                  <label>Register Number</label>
                  <input type="text" id="std_number" name="std_number" required value="" readonly />
                </fieldset>
                
                <fieldset>
                  <label>Joining Date</label>
                    <input name="std_joining_date" id="std_joining_date" type="text" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Course</label>
                  <select id="course" name="course" required>
                    <option value="">Select Course</option>
                                        <option value="6">Class 2</option>
                                      </select>
                </fieldset>
                <fieldset>
                  <label>Year</label>
                  <div id="batch_div">
                    <select id="" name="year" class="form-control">
                      <option value="">Select Batch</option>
                    </select>
                  </div>
                </fieldset>
                </div>
              <div class="panel-heading">
                <h4 class="panel-title">Personal Details</h4>
              </div>
              <div class="panel-body">
                <fieldset>
                  <label>First Name </label>
                  <input type="text" id="fname" name="fname" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Middle Name </label>
                  <input type="text" id="mname" name="mname" value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Last Name</label>
                  <input type="text" id="lname" name="lname" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Date of Birth</label>
                  <div class="input-group date std_dob">
                    <input name="dob" id="dob" type="text" required value="" readonly />
                   </div>
                </fieldset>
                <fieldset>
                  <label>Gender</label>
                  <select id="gender" name="gender" required>
                    <option value="">Select Gender</option>
                    <option value="Male">Male</option>
                    <option value="Female">Female</option>
                  </select>
                </fieldset>
                 <fieldset>
                  <label>Blood Group</label>
                  <select name="blood" id="blood">
      			  <option value="A+">A+</option>
      			  <option value="A-">A-</option>
      			  <option value="B+">B+</option>
     			  <option value="B-">B-</option>
      			  <option value="O+">O+</option>
     			  <option value="O-">O-</option>
      			  <option value="AB+">AB+</option>
      			  <option value="AB-">AB-</option>
      			  </select>
                </fieldset>
                <fieldset>
                  <label>Birth Place</label>
                  <input type="text" id="bplace" name="bplace" value="" readonly />
                </fieldset>
                 <fieldset>
                  <label>Nationality</label>
                  <select name="nationality" id="nationality">
                    <option value="">Select Country</option>
                    	<option value="India">India</option>
		
                  </select>
                </fieldset>
                 <fieldset>
                  <label>Mother Tongue</label>
                  <input type="text" id="mtongue" name="mtongue" value="" readonly />
                </fieldset>
                 <fieldset>
                  <label>Category</label>
                 	<select id="std_cat" name="std_cat" required>
                    <option value="">Select Category</option>
                                        <option value="37">Locl</option>
                                        <option value="38">NT</option>
                                        <option value="39">OBC</option>
                                      </select>
                </fieldset>
                 <fieldset>
                  <label>Religion</label>
                  <input type="text" id="religion" name="religion" value="" readonly />
                </fieldset>
              </div>
              
              <div class="panel-heading">
                <h4 class="panel-title">Contact Details</h4>
              </div>
              <div class="panel-body">
                <fieldset>
                  <label>Present Address</label>
                  <textarea id="present" name="present" required></textarea>
                </fieldset>
                <fieldset>
                  <label>Permanent Address</label>
                  <textarea id="permanent" name="permanent" required></textarea>
                </fieldset>
                <fieldset>
                  <label>City</label>
                  <input type="text" id="city" name="city" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>State</label>
                  <input type="text" id="state" name="state" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Pin</label>
                  <input type="text" id="pin" name="pin" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Country</label>
                  <select name="emp_country" id="emp_country" required>
                    <option value="">Select Country</option>
                    	<option value="India">India</option>
			
                  </select>
                </fieldset>
                <fieldset>
                  <label>Phone</label>
                  <input type="text" id="phone" name="phone" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Mobile</label>
                  <input type="text" id="mobile" name="mobile" required value="" readonly />
                </fieldset>
                <fieldset>
                  <label>Email</label>
                  <input type="text" id="email" name="email" required value="" readonly />
                </fieldset>
              </div>
              
              <div>
               <input type="submit" class="savebutton" value="save"/>
              </div>
               </form>       
          </div>

			<!-- end content -->
		
		
		<div style="clear: both;">&nbsp;</div>
	</div>
	<!-- end page -->
</div>


	<%@ include file="components/footer.jsp"%>
</body>
</html>
